Provider Demographics
NPI:1154534402
Name:MCCARTER, STEPHANIE L (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:L
Last Name:MCCARTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1514
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29465-1514
Mailing Address - Country:US
Mailing Address - Phone:903-268-6452
Mailing Address - Fax:
Practice Address - Street 1:234 SEVEN FARMS DR STE 110
Practice Address - Street 2:
Practice Address - City:DANIEL ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29492-8108
Practice Address - Country:US
Practice Address - Phone:843-388-5995
Practice Address - Fax:833-952-0260
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD89494207R00000X
TXL7806207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
751986041OtherTAX ID GROUP